The long-term impact of urological management on the quality of life of children with spina bifida.

To evaluate the integration of children with spina bifida into adult society and identify important urological factors 20 female and 18 male spina bifida patients older than 18 years were evaluated with respect to urological management and complications. A detailed questionnaire concerning educational achievements, living arrangements, employment and interpersonal relationships was completed and compared to similar data obtained from the 1990 United States census. Educational achievement and living arrangements for most patients were comparable to age matched peers in the general population and were independent of gender or method of urinary management. The only statistically significant factor related to a positive outcome was female gender in the areas of employment (p < 0.014) and sexual relationships (p < 0.005). Female spina bifida patients adapted better to adult society than their male counterparts. Intestinal urinary conduits were detrimental to long-term renal function.